bipolar or extreme emotional trauma?

[dwtfamily]

We adopted our daughter from Russia 14 yrs ago. She is now 15 years old.  When she was almost 10 yrs old, we wrote a letter to her bio mother because we wanted to know any medical history and also to let her know that her bio daughter has a good life and that we love her.  Our daughter was also curious about her bio mother.  So about 6 wks later, we received a letter from her grandmother saying that they had been told that our daughter died (or would not survive) and she was shocked to hear from us.  It took her a while to share the news with her daughter (who is our daughter's bio mom).  About a yr later, we received a letter from her and we got some photos also.  We could see a strong family resemblance and it was another year before we heard from them again.  We eventually began skyping and they speak Russian so we use Google translate to help us.  (We are trying to learn Russian though)  The family is intact and now lives in Israel.  

Last year, we made a trip over there and our daughter had a mental breakdown.  She could not sleep and started hallucinating (the first and only time that has ever happened) and we wound up coming back home early.  We got her some counseling and she seemed OK.  So we went back 4 mos ago and she did great.  She slept (we gave her some melatonin to help) and we had no problems.  I stopped the counseling.  2 mos later, she got very agitated and seemed extremely hyper for about 5 days.  Almost manic.  She wouldn't sleep and she'd be up all night and we might get up and find her in the bathroom washing her face.  She thought it was completely normal.  She would run around in the library grabbing books and she had no idea what she checking out.  Anyway, about a week before this episode, we started talking to her about maybe adopting another child from the foster care system.  I think this really bothered her and we have since dismissed the idea of adopting again.  But in August, she had another similar episode and at the time, we were planning to attend some info meetings on adopting from the foster care system.  So it was on her mind for sure.  But as I said, we are no longer planning to adopt again.  I have had 2 dr's to insist that her episodes are bipolar in nature.  I agree that she was manic both times.  The 2nd time it was like having a monkey in the house.  We had to watch her every move and she would not sleep and neither could we because she would be in her bedroom getting all her clothes out of the closet or something else.  

She is in a depressed state right now.  The dr had prescribed lamictal 5 mg to start.  We have had several other people to suggest that she is in extreme emotional pain and that she needs counseling and her reaction is completely normal considering her stress.  The stress of meeting her bio family.  Her bio family is wonderful and we love them.  Our daughter is dealing with a loss.....the loss of a life she was robbed of by a dr in Russia when she was born.  I believe this is grief.  She is grieving.  She is also 15 and has no idea how to cope.  I have her back in counseling and I am doing my best to help her.  The family dr will not give her an antidepressant because she has been diagnosed with bipolar.  I stopped her lamictal med because I do not believe she is bipolar.  I believe this is a psychological problem that counseling and maybe some other med might help better.  

I hope I have given enough info.  (Maybe too much info, lol)  I guess what it boils down to is that I don't believe my daughter is bipolar but the dr's do.  I know they are pro's but I am her mom.  I don't think they are considering her trauma from meeting her birth family and all that she is now dealing with.  I feel like no one is listening to us and my daughter is in so much emotional pain and I feel helpless.

Patty

[Anonymouse88]

You could start the lamictal again for now.  5 mg is a very small dose, and it takes a long time to titrate up (I started at 25 and am now at 200, but the starting dose is lower for children).  The thing is, your GP is right to be cautious.  If she is bipolar, most antidepressants (the SSRIs) could send her into a manic episode, which is exactly what you don't want.  If you insist on antidepressants, wellbutrin is supposed to be the least likely to cause such a switch (it has a rather unique mechanism for an antidepressant), but it *can* worsen anxiety, so it's not for everyone.  It tends to be good if depression comes with low energy, as it is activating.  

Lamictal is sometimes tried in people with treatment-resistant depression (which, to be fair, could be BP masquerading as repeated depression).  It's very good at dealing with the depressive side of bipolar, and it takes a while to get to the right dose, so it might be worth following the first psychiatrist's titration instructions starting from the beginning, since you usually increase once every 2 weeks, and the target dose for BP (at least in adults) is 100-200 mg.

I know the idea of your daughter having bipolar is not something you want to be true, but the insomnia and hyperactive behavior combined with depressive symptoms is very suggestive of the diagnosis.

And weaver71 is right about journalling--try to get her to write about how she feels (and ensure it's confidential, either in book form or in a private blog or password protected word doc, whatever makes her feel safe), and try to get her to track her moods.  You can find worksheets for it online that you can print out.  These techniques are elements of certain therapies, and the mood charts will be very useful when she does see that new person.  The journalling might also help blow off some steam and internal pressure for her.

[weaver71]

I just want to say, I went 42 years without being treated, it didn't kill me. Your daughter is lucky to have you, she has a huge advantage there. My parents thought I was just rebellious and didn't really mind. I finally found a good therapist and doctor, it took me over a year of searching. I am still waiting to get meds, but one thing about bipolar, if you don't like the way you feel, just wait awhile, it will change. I find writing on these forums helps me, maybe she could try it. Like Virginia Wolfe says, "If you want to know how sloppy your thoughts are, just write them down." I hope you find some relief for her soon, trust me, I know how she feels.

[dwtfamily]

I don't even know how to get decent meds.  I called and got an appt with another child psychiatrist but it's not until Oct 21.  There is no way she can wait that long.  I just don't know what else to do.  She needs something for her depression NOW.

[dwtfamily]

Thank you all for the replies.  

I am so confused and trying to sort things out and trying to get a doctor who will listen.  So difficult!  I appreciate each reply I got to my problem.  I just hate seeing my child in so much pain.  And feeling like the dr's won't do anything.  All because one dr said it's bipolar......therefore the other dr's can't think for themselves.  

[r8rsgrl]

   Although the doctors are pros, what people failed to realize with my
   disorder was that I did not have episodes everyday, day to day, or week
   to week. From what is sounds like, your daughter is only having episodes
  when there is actually something going on in her life that stresses her out.

   I would say take the first step to see as psychologist. To help deal, and
   sort out the things that are happening in her head. Because then, IF
   there is something psychologically wrong, the psychologist will refer you
   to a psychiatrist with their own notes attached. So that way you aren't
   just walking in getting prescribed meds by a blind doctor. Mental
   medicine is not always obvious.

   Trust me, waiting for meds and taking the first step I mentioned is
   WAY better than having to deal with a child whos meds are wrong
   and actually making things worse.

    Best of luck.

[Anonymouse88]

It's possible that both are going on.  There's a theory about mental illness that says you need both the predisposition for it and some sort of life stressor to set it off.  See if you can find out if there's any bipolar, schizophrenia, or depression in the bio family.  If there is, then it makes it a lot more likely that your daughter is bipolar and the stress of finding out about and meeting her bio family is what triggered it.  

Counseling is a good idea no matter what, but I think she's old enough to have some input on the medication decision.  Make sure her therapist educates her about bipolar, and consider going to some group educational therapy sessions to learn more about it and how to cope.  If after that you don't think the bipolar fits, at least the coping skills should be applicable in general.  Going to groups for emotional trauma support might be useful too.

I personally love my lamictal, but I'm 23 (was just shy of 23 when I started it), so I was old enough to do the research and make the decision on my own, and was also severely depressed, beyond the reach of just therapy.

You might want to see a therapist too if you can afford it.  You're going through a lot of stress right now over this, and you feel helpless about it.  A good therapist might help you cope with your stresses and make sure your needs are met.

[weaver71]

Often bipolar and trauma work together. Trauma causes many of the symptoms, but mania is the difference. What does your daughter think? Has she been educated on bipolar and regular depression? At 15 it's hard to tell, I couldn't have been diagnosed that young, my hormones where through the roof. I saw lots of violence, drugs, trauma, etc... as a kid also, so I alway thought it was about my childhood. I am BP1, so it became clear after I had kids. CBT counseling helps a lot, bipolar or not, but a good therapist may be able to get a better diagnosis over time.

[dwtfamily]

I forgot to mention that she now has some anxiety and she said she feels panicky.